If I become pregnant, can I still breastfeed?
Yes.
What happens if I get mastitis or a breast infection?
If not treated early and properly, this can lead to an abscess. Mastitis can occur in the second or third week of nursing; the breast becomes red, hot, and tender, with one-sided swelling, a temperature as high as 101° F, and flu-like symptoms. Treatment should include nursing on the unaffected side first. Treatment with antibiotics, heat, fluids, and a pain reliever such as Tylenol or Advil is also helpful.
What happens if I don’t have enough milk?
It is important to let the baby breast-feed longer, emptying each breast, and to use one breast predominantly for each feeding. Alternating breasts from one feeding to another will help.
Does breastfeeding prevent cancer?
Some studies have found an association between breastfeeding and a reduced risk of some cancers. Breastfeeding appears to have a protective effect against breast cancer. Data also suggest a 20% reduced risk of ovarian cancer.
Will I experience weight gain while I breastfeed?
Usually women will NOT gain weight, however there are many factors involved in weight gain.
I have had breast surgery. Can I breastfeed?
Some women who have had three to four incisions for fibrocystic breast disease may have some damage to collection ducts, but this rarely interferes with breastfeeding. Breast reduction surgery may be a problem, because the surgical techniques done in the past destroyed some of the duct system. Most breast implants are placed under the breast tissue, where they should not interfere with breastfeeding.
If the baby is premature, can I breastfeed?
Yes. Breast milk is particularly good for premature babies even if it has to be administered through a tube.
Can I breastfeed if I have to return to work?
Yes. Many companies are making it easier for women to breastfeed and pump milk at work. If exclusive breastfeeding is impossible, partial breastfeeding in the morning and at night is an option.
I want to breastfeed and I have small breasts. Will I be successful?
Breast size does not correlate with breastfeeding ability. Some women with very small breasts cannot breastfeed, but this is a rare condition.
My physician has recommended an abdominal hysterectomy. What are my options? What is a “DaVinci” hysterectomy?
Please go to Davincisurgery.com to find out more information.
I have a vaginal discharge and irritation that is not improving with over-the-counter medication. What should I do?
There are many causes for these symptoms such as infections with viruses, Trichomonas, bacteria, yeast, and so on. The only way to find out what is causing the problem is to have an examination with a microscopic evaluation of the discharge. Over-the-counter medication may be used for certain conditions, but if the symptoms do not improve, an exam will be necessary.
What is osteoporosis?
Osteoporosis is a thinning of the bones and is most frequently seen in postmenopausal women. It is a silent process that makes the bones weak and brittle. When this happens, a minor fall can cause a fracture which sometimes requires major surgery (e.g. a broken hip). This disease is not related to arthritis. Treatment for osteoporosis includes hormone replacement therapy and other medications. Adequate calcium and vitamin D and weight bearing exercise maximize the effects of medication. It is also important for teenagers and young women to maximize their bone strength by consuming diets containing adequate calcium (1200 mg per day). Also, prevention of osteoporosis includes refraining from smoking and minimizing alcohol consumption.
I have an abnormal Pap smear. What should I do?
A Pap smear is a screening test for cancer. However, the vast majority of abnormal Pap smears are not due to cancer. Some abnormalities are due to inflammation or inadequate numbers of cells, and may be managed simply by repeating the Pap smear after treatment of the cause of the inflammation. Pap smears showing atypical or precancerous cells are best evaluated by a procedure called colposcopy. During this procedure, the doctor examines the cervix, vagina, and vulva using magnification. Areas of abnormality are sampled with a biopsy and a treatment plan is recommended. Many minor abnormalities are observed by means of frequent Pap smear combined with periodic colposcopy. Some abnormalities are treated using electrical excision, known as LEEP, an office procedure. If cancer cannot be ruled out by means of colposcopy, then a more extensive biopsy of the cervix called a conization needs to be performed.
I have a lot of pain with my periods and have been told I have endometriosis. What does this mean?
The lining of the uterine cavity is called the endometrium. If this tissue gets outside of the uterus, it can implant and grow in various areas of the pelvis and abdomen. This is called endometriosis. It is a common cause of pelvic pain and can cause infertility. The location and extent of the endometriosis as well as the degree of symptoms would determine the treatment necessary. Treatment must be individualized, and can range from observation, medical therapy, to minor and major operative procedures.
We have been trying to get pregnant for over a year and have been unsuccessful. What can be done?
Fertility problems occur in about 15% of the population. Approximately 35% of couples with difficulty conceiving have more than one problem. A full evaluation is important to find out the exact cause of the fertility problem. Areas targeted for evaluation include a sperm count, ovulation, an analysis of the Fallopian tubes, and various hormones. After evaluation, a treatment plan can be instituted. Sometimes a referral to an infertility specialist may be necessary.
I am 60 years old and haven’t had a period for 9 years. I have just started bleeding again. Is this a problem?
Most bleeding after menopause is due to a benign condition, however cancer needs to be ruled out. All postmenopausal bleeding (defined as bleeding after a one year absence of periods) needs to be evaluated promptly.
My periods used to be every 28 days, but now they come every 2 to 6 weeks. What is wrong?
There are several causes for abnormal uterine bleeding. Hormonal imbalance involving the thyroid gland, adrenal gland, pituitary gland, or ovaries may be the problem. The other common cause involves structural abnormalities of the uterus, cervix, or vagina. These include polyps, uterine fibroids, precancerous changes or even cancer. It is extremely important to be evaluated promptly when these problems occur. Many times, these evaluations can be entirely performed in the office. Sometimes, however, the evaluation requires surgery such as hysteroscopy, usually done as an outpatient.
I have been told that my uterus in enlarged and that I have fibroids. What does this mean?
The uterus is mostly made of muscle. When tumors in this muscle develop, we call them fibroids. Only rarely are they cancerous. These muscle tumors can distort the uterus and enlarge it, sometimes leading to abnormal bleeding. They can also cause pressure symptoms and problems by pressing on adjacent structures in the pelvis. These can lead to bladder, kidney, bowel problems, pain, etc. The management of the fibroids depends upon their size and the symptoms they are causing. There are times when treatment is not necessary, but surgical treatment might be recommended in other cases. You may schedule a consultation with Dr. Hage to discuss your options for treatment.
I am 40 years old and am having irregular periods and hot flashes. Is this menopause and how long will these symptoms last?
The average age of menopause in the United States is 52. The classic definition of menopause is one year without any periods, however, symptoms can occur much earlier. The classic symptom of menopause is the hot flush or flash. Problems that arise because of decreased estrogens at menopause are significant. The most worrisome is an increase in coronary heart disease and stroke, but there are other significant problems such as osteoporosis (thinning of the bones), urinary bladder and pelvic support problems, Alzheimer’s disease, etc. We know that hormone replacement therapy (HRT) can markedly reduce or eliminate many of these problems. HRT using Estrogens and Progestins has some health risks and there are many options for therapy. The patient must understand the risks of HRT compared to the benefits before initiating therapy. For more information on HRT, risks, benefits and alternatives, you may schedule a consultation at our office.
I am 35 years old and hoping to become pregnant soon. What are my risks because of my age?
Older women appear to have an increased risk of several things when they become pregnant. Medical problems such as high blood pressure and diabetes are more common. Miscarriage rates increase and fertility rates decrease. However, one of the biggest concerns is the greater risk of certain chromosomal abnormalities as the woman’s age increases. The most commonly known one is Down’s syndrome, however other syndromes are also increased. Women who are 35 at the expected date of delivery are offered genetic testing. The final decision about getting tested however, is that of the patient, not the doctor.
My first baby was born by Cesarean. Will I need to have another Cesarean?
We do not offer vaginal birth after Cesarean (called VBAC or also TOLAC for Trial of Labor After Cesarean), however, if you are interested in a VBAC, we will gladly arrange a referral for you to a facility that may be able to assist you. Most women may attempt a VBAC after one C-section, depending on the type of uterine incision made previously. However, there is a risk of the uterine scar separating and this occurs in up to 1 percent of labors after C-section. The decision to attempt VBAC should be a mutual decision made with your obstetrician.
I am pregnant and need to take medication prescribed by another doctor. Is this safe during pregnancy?
Some medications for ongoing medical problems need to be taken throughout pregnancy in order to keep those problems under control. No one can guarantee the safety of any medication during pregnancy, so we have to weigh the risk of taking the medication against the benefit. In general, during the first three months, only medications essential for your health should be taken because this is when the baby’s organ systems are forming and any birth defect potential would be maximal. After that there is less risk to the baby, except for a smaller group of drugs. It is never a good idea to stop any prescribed medication without first discussing it with your doctor.
I am considering getting pregnant within the next few months. Is there anything I should be doing now?
If you have any medical problems now or in the past, you should be evaluated before conceiving. If you have diabetes, high blood pressure or any other medical conditions, your condition should be well controlled and stable before you conceive, in order to prevent birth defects and lower the risk of miscarriage. It is also important to have good nutrition and consume enough folic acid daily at a dose of 0.8-1.0mg. It is advisable to take prenatal vitamins daily prior to conception. There are many other things that should be addressed before conception. This is a good reason to schedule a preconception visit with Dr. Hage.